Chad Karls, a principal and consulting actuary at Milliman who specializes in medical professional liability, said frequency in 2008 and 2009 is no longer falling and has even increased in some spots.

“That needs to be kept in perspective,” Karls said. “While it may be increasing, I don’t see it at the 2002-03 levels.”

Karls was referring to a tumultuous period for medical professional liability of nearly a decade ago. It arrived after the largest medical malpractice writer in the United States chose to forego the line and take a $900 million write-down. St. Paul Cos., which has since merged with Travelers, had written 9% of that sector’s direct premium in 2000 before pulling out, according to A.M. Best data.

What followed was a call for tort reform measures to mitigate jury awards and litigation costs, along with a heightened public awareness of the rising insurance costs that physicians faced. Karls said the medical community successfully framed that pushback effort as an access-to-care issue for patients at large.